KEEPING FIT : Laughter’s No Cure-All, Cousins Warns : The man who became a medical legend for laughing himself to health tells an Orange County audience it’s just one tool in an arsenal of positive emotions and remedies.

Laughter may not be the best medicine after all, says no less an authority than Norman Cousins himself.

Cousins, who became a medical legend for laughing his way out of a painful, crippling degenerative disease, wishes the oft-told tale of his recovery hadn’t become quite so simple over the years.

“I’m a little embarrassed at all that ‘laugh your way back’ stuff,” he said last Tuesday in a visit to mark the opening of the Wellness Community Orange County. “I don’t want people to think they can make any problem disappear just by ha-ha-ha-ing it away.

“Laughter can make a difference. For example, it can increase the number of cancer-fighting cells in the body. But I don’t want people to think it’s the be-all and end-all of treatment.”

The writer-turned-medical-professor still gives laughter its due as a weapon against disease. But he sees it as just one tool in an arsenal of positive emotions. Even though it’s the best known, thanks to his writing, he says laughter isn’t even the most potent.

“Hope is the most powerful medicine in the human armamentarium,” Cousins told a crowd of about 300 Wellness Community clients and supporters gathered for the opening ceremonies at the site in Santa Ana.

“I’ve used laughter as a metaphor for the full range of positive emotions: hope, faith, love, laughter, determination. We are now discovering, through systematic research, that the positive emotions represent a specific physiological force.”

When Cousins says “hope,” he isn’t necessarily talking about hope for a full or swift recovery. “There should be a sign on the door here: Prepare yourself for the experience of realistic hope,” he said.

“The body has its own form of chemotherapy,” Cousins said. “But obviously, this doesn’t work all the time. We’re not immortal. There will always be that statistically certain, final and fatal illness. The important thing is what we do while we’re alive. The great tragedy of life is not death, but what dies inside us while we live.”

The Wellness Community, founded eight years ago in Santa Monica by Harold Benjamin, a Beverly Hills attorney who had studied the psychosocial aspects of cancer patient care, gained widespread attention after the late actress-comedian Gilda Radner wrote about her experiences there in the book “It’s Always Something.”

Now 12 Wellness Community centers are in operation or development in cities all over the United States, including the new Orange County center, with more to follow, according to Benjamin. The centers provide support groups, counseling and other resources to cancer patients at no charge.

The community offers no promises of recovery to its clients, said Orange County Supervisor Harriett M. Wieder, who spearheaded the drive to establish the center here. “But they help people overcome the feeling that they’ve lost control, which can be devastating to people with cancer,” she said. “You can take control of your own life, and the quality of your life.”

Wieder became familiar with the Wellness Community more than five years ago when her sister, Estelle Ullman, was battling pancreatic cancer. After seeing how much her sister was helped by the group’s programs during what turned out to be a terminal illness, Wieder decided to try to establish a center here as a tribute to her sister.

Neither Cousins nor Benjamin advocates relying solely on emotional weapons against cancer or other infirmities.

“If I had to choose between medical treatment and that which we provide, I would choose the medical treatment,” Benjamin said. “But I think we provide a significant adjunct to total cancer patient care.”

“If you treat just the disease without treating the emotional devastation caused by the disease, you’re only treating half a patient,” Cousins said.

Doctors have long accepted the fact that negative emotions can affect the body, Cousins said. “It doesn’t seem reasonable to believe that the only time the body is affected by emotions is when those emotions are negative. We now have scientific evidence that the human body works both ways.”

At UCLA, where he is an adjunct professor at its School of Medicine, Cousins and other researchers studied the effects of positive emotions on 75 patients with malignant melanoma. The patients were divided into two groups, he said. Both had the same access to medical treatment, but one of the groups also received information and counseling on emotional resources. “They got information on how to cope, and how to hope,” he said.

The researchers plotted two factors on a graph: the level of depression in the patients, and the level of interleukin cells--part of the body’s natural defense against disease.

“For the first two months, there was very little difference. But in the third month, the depression level (in patients who received emotional counseling) dropped, and the interleukin level went up. The control group, meanwhile, had a slight increase in depression, but no increase in interleukins.”

Cousin spends most of his time--and finds the most meaningful rewards--dealing with seriously ill people both in person and in correspondence. Almost as a sideline now, he continues the writing career he had before he got involved in the field now known as psychoneuroimmunology.

Wieder called psychoneuroimmunology “the medicine of the 21st Century.”

Since its founding, the Wellness Community and its satellites have served more than 14,000 cancer patients. The Orange County center opened unofficially last month, with more than 120 participants in its first sharing group. The center already has more than 350 clients.

Benjamin envisions a time when Wellness Communities, or centers like them, are in every city.

Not only that, but “someday I would like to see a program of this nature for every illness,” he said. “We’ve kept our focus on cancer, but there’s no reason people with other diseases could not benefit.”

The Wellness Community is at 1924 E. Glenwood Place, Santa Ana. (714) 258-1210.